Abstract

Background: Although the effect of thyroid hormones is very important on renal function and glomerular filtration rate, it is often overlooked. Hypothyroidism is sometimes accompanied by a decrease in the glomerular filtration rate and hyponatremia. Observation: A33-year-old man was admitted in intensive care unit for an inaugural diabetic ketoacidosis in December 2012. He has been diagnosed as hypothyroidism case since 2005. He had a replacement therapy that he had given up in 2011. On The physical examination he exhibited a general fatigue with fever and sweats. He suffered from myalgia and proximal muscle weakness, edema of renal type and a few crackles. The biology showed ketoacidosis, progressive acute renal failure of deterioration associated with important rhabdomyolysis and proteinuria of 5.7 g/24 h. Normal eye fundus was able to rule out diabetic nephropathy. In addition to the treatment of ketoacidosis, lung disease and the fluid overload, hormone replacement therapy was reinstituted. The evolution was marked bythe disappearance of edema, fever, rhabdomyolysis and proteinuria. Discussion: The rhabdomyolysis, secondary to hypothyroidism, is atthe origin of renal failure. In this case, proteinuria is exceptional. Themajor part of the renal manifestations during thyroid dysfunctions isreversible with hormone therapy. Conclusion: Transient proteinuria isexceptional in hypothyroidism. It is another face of kidney involvementin thyroid disorders.